Do you experience any difficulties while sleeping at night?
Yes
No
If yes, can you list any of these difficulties?
Do you think that reduced sleep time is affecting you?
Yes
No
If yes, can you choose how a reduced sleep time is affecting you?
Always Tired
Mood swings
Low Immunity
Loss of Appetit
Do you know of any consequences of not getting enough sleep?
A great deal
A lot
A moderate amount
A little
None at all
Do you think you are experiencing any of these consequences?
Yes
No
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